The US Centers for Disease Control and Prevention (CDC) has issued official travel health notices for Haiti and India following confirmed cases of rabies in American travellers returning from these countries.
Level 1 Advisory: Practice Usual Precautions
Last week, the CDC enacted a Level 1 travel health notice for both nations, advising travellers to practice usual precautions. This includes ensuring vaccinations are up to date, practising frequent handwashing, and crucially, avoiding contact with stray or wild animals.
The warnings were prompted by Haiti reporting a rise in rabies cases among animals. Rabies is a nearly always fatal viral disease once symptoms begin. It is typically transmitted to humans via the saliva of infected animals through bites or scratches.
Health authorities confirmed one case of rabies in a person who had travelled from Haiti to the US, and another separate case from India. No further details about these individuals have been released.
Counterfeit Vaccine Risk in India
Adding to the danger, the CDC reported that counterfeit versions of the critical human rabies vaccine ABHAYRAB are circulating in several major Indian cities. These fake vaccines may be ineffective and could contain harmful ingredients.
Genuine rabies vaccine is 100% effective if administered before symptoms appear. In the US, the vaccines Imovax Rabies and RabAvert are commonly used. Travellers are urged to seek medical care immediately if exposed, even if vaccinated prior to travel.
Essential Safety Advice for Travellers
The CDC's guidance for those visiting Haiti or India is explicit:
- Avoid all contact with dogs, cats, and wild mammals, especially strays.
- Consider a pre-travel rabies vaccination if you might encounter animals or work in high-risk areas.
- If bitten, scratched, or licked on an open wound, immediately wash the wound with soap and water and seek urgent medical attention.
The article referenced the case of Erica Kahn, who was photographing in Arizona when a bat flew into her mouth, highlighting that risks exist globally. Rabies moves from the spinal cord to the brain, causing inflammation.
Early symptoms include fever, headache, and agitation, progressing to restlessness, hallucinations, excessive salivation, and a fear of water. Only 20 human survivors of symptomatic rabies are recorded in global medical literature.
While fewer than 10 Americans die from rabies annually, the global burden is severe. India accounts for over one-third of the world's rabies deaths, with 18,000 to 20,000 fatalities yearly, mostly children under 15. In Haiti, an estimated 100 to 130 people die annually, with true figures likely higher.
The only prevention or cure is a series of four to five vaccine doses administered promptly after potential exposure.
